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Accreditation is the granting of approval or credentials to an agency or facility, based upon that agency or facility demonstrating (usually by passing a specific survey or inspection) that standards prescribed by the accrediting board have been met.  Home health care organizations, laboratories, hospitals, nursing homes, ambulatory surgery centers, behavioral care organizations, rehabilitation hospitals, and other health care facilities all receive some sort of accreditation before they may treat patients.  Health insurance plans may also seek accreditation from certifying agencies.  In the United States, hospitals and other types of health care organizations are highly motivated to do well during Joint Commission surveys, since accredited organizations are deemed by the Centers for Medicare and Medicaid Services (CMS) to meet Medicare and Medicaid certification requirements.  These certifications are necessary for gaining reimbursement from Medicare and Medicaid programs (see,, ).


The main health care accrediting agencies in the United States are the Joint Commission, DNV,  the National Committee for Quality Assurance (NCQA), and the Healthcare Facilities Accreditation Program (HFAP), founded by the American Osteopathic Association (


History of Accreditation   

The first hospitals in the United States were accredited by the American College of Surgeons in an effort to promote hospital reform based on outcomes in management of patient care. The American College of Surgeons’ hospital standardization program was merged in 1951 with similar efforts by the American College of Physicians, the American Hospital Association, the American Medical Association, and the Canadian Medical Association.  The new entity was called the Joint Commission on Accreditation of Hospitals. In 1987, the organization was re-branded as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO, pronounced "jay-co"). It is now known as The Joint Commission. (see,


In 2006 Det Norske Veritas (DNV), an international certification body based in Norway, sought to provide an alternative to accreditation for hospitals by The Joint Commission.  It subsequently applied to CMS for deemed status, which was granted in 2008, becoming the first new option for hospital accreditation in more than 40 years.  DNV developed the National Integrated Accreditation for Healthcare Organizations program, which blends the ISO 9001 quality management system with Medicare’s Conditions of Participation for Hospitals. (


NCQA began accrediting health care plans in 1991, in response to the need for standardized, objective information about the quality of these health care organizations.  NCQA accreditation includes an assessment of the care and service that health plans deliver in important areas like providing childhood immunizations and ensuring that women receive mammograms as appropriate. 


With respect to hospital surveys, The Joint Commission does not make its findings public. However, it does provide its accreditation decision, the date that accreditation was awarded, and any standards that were cited for improvement. Organizations deemed to be in compliance with all or most of the applicable standards are "accredited."